Posts tagged ‘MRI’

October 29, 2014

Donuts, Bagels, Claustrophobia and MRIs

1024px-Plain-BagelFor people with severe claustrophobia, MRIs can be intimidating. Even people who are only mildly claustrophobic may find MRI exams stressful – but they don’t have to!

 

The best imaging technologists and radiologists will always work with patients to provide feelings of safety and comfort during MRI procedures.

 

The first step in managing stress and claustrophobia comes in arming yourself with information. Information on how long the exam will take and how you will be positioned in the magnet can help prepare you.

 

Here are a few tips and tricks for the time you may find yourself in a donut-shaped machine:

 

  1. For many with mild claustrophobia, two things will help the most: covering your eyes and practicing visualization exercises. While this may sound “new age”, these sorts of mental exercises have been shown to get people through their MRIs. The best thing is to concentrate on breathing and on visualizing in your mind a calm, open space – one you find restful. Get that picture in your mind – a beach, a meadow, a mountain slope – someplace wide open. Get the smells and sounds in your mind as well. Keep coming back to it – it will work! This in conjunction with talking with the technologist throughout the study will get you through the test in no time.
  2. Because MRIs are loud, ear protection is provided. Some clinics offer music as well, which can be calming.
  3. If the above isn’t working, consider asking for a procedure done on an open bore magnet – the latest in technology is a more open cylinder design, still with a high field strength magnet (our Olathe clinic has such a machine!). True open MRI units may be an option as well, but those may be lower strength magnets and imaging times can be longer!
  4. If claustrophobia is still an issue, you may need to seek some help from your doctor or the radiologist. Some doctors who refer patients with claustrophobia for an MRI will write for a prescription for an anti-anxiety medication, like valium, to be taken prior to imaging. At some facilities, your radiologist will be able to provide medication, often Xanax, but make sure this is discussed with the facility beforehand as it may mean changes in how your prepare for the study, and it will require you to have someone available to drive you – no machine operating after these types of anti-anxiety meds!

 

Armed with this knowledge and the help of caring technologists and staff, you can survive the MRI experience. And with medical imaging comes the ability to diagnose and get you on the road to your best possible health!

Plain Bagel by Evan-Amos (Own work) [Public domain], via Wikimedia Commons

 

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

October 9, 2014

MRI: Not If You’re the Tin Man

Tin Woodman by William Wallace Denslow via Wikimedia Commons Copyright Public DomainWhat are the risks of an MRI?

The main risks of MRI come from the fact that the machine is made up of a giant magnet – which is never turned off.

 

Safety for MRI studies relies on removing any metal on your body and fully understanding the impact of any metal within your body. Many types of metal implants, like joint replacements, are not a problem and patients with them can safely undergo MRI.

 

Some battery operated implants, like most pacemakers and many neurostimulators, can be adversely affected when exposed to the magnet. The safety of any implanted surgical device or metal should be thoroughly discussed before the exam – preferably at the time of scheduling.

 

On the day of the procedure, removing all metal (all hairpins included!) prior to entering the MRI suite is important for the safety of you, the technologist and the machine. No metal in clothing, no metal in pockets, no watches or phones!

 

The other main risk of MRI comes from those studies that require the injection of IV contrast. This allows us to evaluate blood vessels and the vascularity of organs and masses. This contrast contains gadolinium which is a heavy metal. Allergies or reactions can occur, although rarely. Gadolinium contrast materials should be used with caution in those at risk for kidney disease. You will be screened for the possibility of kidney disease, and your kidney function may be evaluated with a simple blood test before we give you the contrast if you have risk factors.

 

MRI is an amazing technology but requires strict safety precautions for everyone. We’ll be writing more about MRIs and the claustrophobic patient in our next post – stay tuned!

(Image credit: Tin Woodman by William Wallace Denslow via Wikimedia Commons Copyright Public Domain)

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

October 6, 2014

MRI: It’s a Magnet!

Magnet by AJ Cann via Flickr Copyright Creative Commons Attribution-ShareAlike 2.0 Generic (CC BY-SA 2.0)Radiology can be confusing. How these exams work can confuse the smartest people. As radiologists, we get lots of questions. Which exams use radiation and which do not?  How safe is the exam?

 

Today we will attempt to answer some of your questions and concerns about magnetic resonance imaging or MRI.

 

MRI – how do we make images?

MRI or magnetic resonance imaging, is one way of viewing the body that uses NO radiation (a plus!). We can create amazing images of all parts of the body with… a magnet! MRI machines are loud, clunky-sounding machines made up of a giant magnet. The noise comes from the second part of the name – resonance, or radiofrequency waves. This combined with computers creates images of the body. And, oh, the things we can learn about you with this technology.

 

The MRI Experience

Having an MRI involves being positioned on a table and moved inside the MRI unit. The inside of the MRI is called the bore and is basically a long tube the size of which varies. We center the body part being evaluated within the bore.  Bore sizes and configurations vary depending on the magnet strength and configuration of the MRI unit.

 

“Open MRI” units have a more open environment for imaging.  They are often used for the claustrophobic patient or larger patients.  The open MRI units can have limitations of longer exam times and lower quality of images. This is because the signal created and used to make the images is directly related to the magnet strength – which is lower for some open magnets.

 

High field magnets or traditional MRI trump an open magnet when we want imaging speed and precision, so it’s highly encouraged when at all possible. It can be done! There are many ways we can help our patients be comfortable while getting the highest possible quality images.

 

Over the next few days we’ll talk more about MRI safety as well as limiting patient discomfort in the machine.

 

In the mean time, cheers to your best possible health!

(Image credit: Magnet by AJ Cann via Flickr Copyright Creative Commons Attribution-ShareAlike 2.0 Generic (CC BY-SA 2.0))

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

September 29, 2014

Do you like to save money? Medical costs and quality care…

Kitten by Michael Richardson via Flickr (CC BY 2.0) note derivWhen it comes to lowering medical costs – the power can be in your hands! (Would you believe it? Because it doesn’t always feel that way…). The old motto about the customer always being right (customer = patient = you) is true. Shopping around can have a profound effect on the market, both in terms of pricing and level of quality. But this only matters IF you know you have options…

 

Price transparency in medicine is a relatively new concept. With payment of physicians, hospitals and other health-care providers done by insurance, most of us have never known how much a particular office visit, lab test or procedure actually costs. Those times are changing.

 

In the journal Health Affairs, a study titled “Price Transparency For MRIs Increased Use Of Less Costly Providers And Triggered Provider Competition” caught our eyes. (And not just because it was in the New York Times, though it was.) This study showed that when the cost of an MRI was known, going to the less costly provider happened more often. Makes perfect sense to us!

 

Price transparency makes sense because:

 

Reason number one: Patients aren’t always aware they have a choice in where to go for medical tests including imaging. Costs can vary greatly – sometimes by a factor of ten. If you pay a percentage of the cost of the test, the less a test costs, the less you pay. Simple math.

 

Reason number two: The math isn’t always simple though if you can’t get the numbers. Getting accurate pricing information can be a challenge, particularly from hospitals and large health-care enterprises. Does the price include all charges? Sometimes impossible to tell until after the billing starts.

 

We believe getting accurate, complete pricing information on the tests you are about to undergo is your right.

 

Price transparency in medicine – the time has come.

 

 

(Image attribution: Kitten! by Michael Richardson via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0) note: derivative work)

 

 

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

September 22, 2014

We Love… Prostate Cancer Networking Group!

PCNGWe love Prostate Cancer Networking Group… and we think you should like them too!

 

In Kansas City, this wonderful organization seeks to help:

 

Men who have, or have had, prostate cancer give valuable support to others through their involvement with the prostate cancer networking group.  Just as men have received support from this group, they can in turn offer other patients and their families patience, strength, and endurance through their experiences with diagnosis, treatment and recovery.

 

Isn’t that just what the doctor ordered? Cancer care reaches far beyond treatments and deeply into the lives of those affected by it.

 

Emotional support isn’t spoken of nearly often enough when it comes to the Big Battle – partly because patients are so focused on physical well-being that repercussions elsewhere in life fall second to simple survival. But to live the best possible life during and after cancer is our wish for all those who fight… and the Prostate Cancer Networking Group is here to fill that gap!

 

As doctors, our biggest hope is to see and end to cancer entirely.  Until then, we work as a team providing care and support needed. Everyone deserves a guide on the road to their best possible health and we appreciate Prostate Cancer Networking Group for filling that role for men with prostate cancer!

 

PCNG meets regularly:

We invite all prostate cancer survivors, their partners and those helping in the fight to join us.”

Meetings held 3rd Wednesday, monthly 6:30 – 7:30 PM

Gilda’s Club Kansas City 21 West 43rd KC, MO

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

September 19, 2014

Pattern Baldness: Prostate Indicator Light?

Larry David at the 2009 Tribeca Film Festival by David Shankbone via Wikimedia Commons Copyright Creative Commons Attribution 3.0 Unported (CC BY 3.0)If the trashcan is tipped over AND you see the dog racing out of the kitchen, you may assume that one caused the other to happen. It’s a common way of looking at the world.

 

However, the dog may just be chasing a naughty four-year-old from the room… IF something happens about the same time as something else, did one cause the other?

 

In medicine, studies ask this question all the time.

 

A recent study in the Journal of Clinical Oncology suggests there’s a relationship between a specific type of baldness and aggressive prostate cancer. This study proves a relationship, but does not answer the question of cause.

 

As with too many cancers, we don’t know what causes prostate cancer, but we can identify risk factors (age and family history most importantly). This study newly identifies baldness as a risk factor for prostate cancer. With certain types of baldness, the risk of aggressive prostate cancer was increased by 39%. That’s a big increase!

 

What type of baldness was associated with this significant increase in cancer risk? So called male pattern baldness is the type associated with prostate cancer risk. This is the type of baldness you most often associate with older men – hair loss at the crown of the head in conjunction with a receding front hairline. So, should this type of hair loss send you running to the oncologist’s office? No. But knowing the risk of prostate cancer is increased should mean increased vigilance. Regular screening exams are important for those at high risk – and that’s the most important takeaway from this study.

 

No matter what, embrace the hair you have (or don’t) and take care of the rest of your body too. That’s how you stay on the road to your best possible health!

(Image Credit: Larry David at the 2009 Tribeca Film Festival by David Shankbone via Wikimedia Commons Copyright Creative Commons Attribution 3.0 Unported (CC BY 3.0))

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

September 15, 2014

Prostate Health: 4 W’s + an H

Elderly_exerciseProstate health awareness is lagging in the national conversation and plaguing men in the United States. We’ve all heard the 1-in-8 statistic for women’s breast cancer… but do you know the number for men’s prostate cancer? Hold onto your hats: this is a 1-in-7 occurrence.

 

What do these numbers add up to? More than a quarter million men in the US will be diagnosed with prostate cancer this year and 30,000 will die from it.

Why is prostate cancer so serious? Prostate cancer is the second most common cancer in men (just behind skin cancer), and the second most common cancer-killer for men (just behind lung cancer). If signs and symptoms show up and are handled appropriately, a prostate cancer warrior can turn into a prostate cancer survivor – and join the 2.5 million healthy others in this country.

 

Who is at risk? The answer is every man. For better or worse, prostate cancer occurs mostly in men over the age of 65 (66 is the average age of detection) and is seldom seen in men under the age of 40. Though no one knows for certain what causes prostate cancer, there are certain risks to be aware of for prostate cancer:

 

Main risk factors for prostate cancer:

 

  • age over 60
  • African American men are more often affected and may have more serious (advanced stage) disease
  • genetics plays a role in prostate cancer in a small percentage of cases
  • family history, particularly if prostate cancer is present in a brother or father
  • family history when prostate cancer is seen in a brother or father before the age of 65 is even more important in risk
  • some studies have shown a link to higher consumption of red meat

 

Possible signs and symptoms:

 

  • Most men will be asymptomatic! Or..
  • Blood in urine.
  • Impotence.
  • Pain in bones of the back, chest and hips.
  • Trouble urinating.

Where do we go from here? Because early stages of prostate cancer are not associated with signs or symptoms, regular screenings are imperative. To understand your personal risk and to figure out what steps you should be taking, have a discussion with your doctor.

 

How do we look for prostate cancer? The screening tests include digital rectal exam (DRE) and prostate-specific antigen (PSA) blood tests. These two steps are the cornerstone of screening asymptomatic men for the disease. These should begin around the age of 50 for average risk men, possibly earlier for those at higher risk due to family history or for African American men. If either of the screening tests is abnormal, further evaluation by a urologist will likely follow. Prostate ultrasound and biopsy may be the next step. Prostate MRI may be indicated in some men as well, particularly for problem-solving complex cases.

 

For more information, here’s a link to the American Cancer Society prostate health site. Special thanks to Kansas City Urology Care for sponsoring the Zero Prostate Cancer Run/Walk!

(Image attribution: “Elderly exercise” by National Institutes of Health. Licensed under Public domain via Wikimedia Commons)

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

August 4, 2014

We Love… Get Your Rear In Gear!

Katie Couric VF 2012 Shankbone 2 by via david_shankbone Flickr Copright Creative Commons Attribution 2.0 Generic (CC BY 2.0)To end this series on GI imaging, we thought we’d shine a light of hope and health by talking about an organization we love… Colon Cancer Coalition!

 

This is an amazing group of people dedicated to the knowledge that early detection of colon cancer saves lives! Their mission?

 

“Empower local communities to promote prevention and early detection of colon cancer and to provide support to those affected.”

 

Katie Couric, through her own personal loss and resilience, has helped make colorectal cancer a nationally known and talked about  issue (and for this we are grateful). The Colon Cancer Coalition reminds us to Get Your Rear In Gear! This program in cities across the US funnels money back into the participating cities, supporting local education and screening efforts. Check for events in your community here.

 

Early detection is the key to saving lives from colon cancer which is a largely preventable disease – in most cases, colon cancer starts from small growths called polyps. If these are found early, no colon cancer will develop! From a healthy diet and exercise to regular check-ups and knowing the signs of colon cancer, we can all make a difference. Regular screening with colonoscopy at age 50 for folks of average risk can and will make a difference.

 

Catch up with the Coalition on Twitter. (We follow them too.)

 

Time to celebrate life – and kick cancer’s butt!

 

 

(Image credit: Katie Couric VF 2012 Shankbone 2 by david_shankbone via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0))

 

 

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

July 30, 2014

MR Enterography

MR enterographyWhen investigating issues of the abdomen and intestines, there are multiple options, including small bowel series, small bowel enteroclysis and CT or MR enterography (entero- meaning intestine, our linguistic lesson for the day!).

 

Why would you need MR enterography?

 

MR enterography is performed for many of the same reasons as CT enterography. As with each imaging modality, there are nuances and benefits from the different techniques.

 

One of the reasons a patient may come in for MR enterography is due to an iodine allergy (iodine is the IV contrast agent for CT). MR technology uses a different IV contrast agent, one containing gadolinium.

 

Additionally, MR technology uses no radiation. This can be beneficial when the patient is pregnant (although only done in pregnancy after the first trimester). It is an ideal means for assessing younger patients with inflammatory bowel disease who may face the need for frequent, repeated imaging of the intestine.

 

How does a patient prepare for MR enterography?

 

Preparation for MR enterography is done similar to the CT version – fasting for up to 4 hours before the examination.

 

What can be expected when you have MR enterography?

 

As always, remember your basic MRI safety – no metal can enter the MR suite – this means all clothing with metal must be removed.

 

MR enterography relies on adequate distention of the small bowel, usually using the same oral contrast agent containing iodine as for CT enterography. Images of the abdomen and pelvis will be obtained while IV contrast containing gadolinium is injected. The imaging time is longer for MRI than for CT, usually close to 30 minutes total for MR. Holding still is important as any motion will cause loss of detail.

 

What can we find with MR enterography?

 

This can show vascular lesions of the wall of the GI tract, masses and mucosal lesions as can be seen with inflammatory bowel disease. It also allows us to see detail in the bowel wall and in the adjacent soft tissues. Fistulas (abnormal communications from bowel loops), strictures and blockages, and abscesses can be seen in patients, often in those with inflammatory bowel disease. Problems with the blood vessels going to the bowel will be shown, such as narrowings or aneurysms.

 

And after the exam?

 

To flush the excess contrast from your system – drink lots of water!

 

MR enterography is one more tool in the arsenal for imaging the small intestines able to produce beautiful images helping us keep you on the path to your best health.

 

 

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

July 9, 2014

Barium: Great for Imaging, and Okay for Puns

Bariumsulfaat by Dr.T via Wikimedia Commons Copyright Creative Commons Attribution-Share Alike 3.0 UnportedImaging of the gastrointestinal system can be done many ways, using scopes, fluoroscopy/x-rays, ultrasound, CT and MRI studies. The gastrointestinal (GI) system includes everything from the mouth or oral cavity and esophagus down to the rectum and anus. The GI tract can be thought of as one long hollow tube, and filling the tube with fluid to image it with xrays was one of the earliest techniques developed when radiology was in its infancy.

 

This technique is still used today with barium sulfate the most commonly used contrast agent. Barium blocks the xrays from travelling through the body resulting in a white appearance on the image. Since its first development, many different forms of barium are now available allowing us to see different parts of the GI tract in detail.

 

Barium studies include UGIs (upper gastrointestinal exam to evaluate the esophagus, stomach and the first part of the small bowel), esophagrams (to image the esophagus), small bowel series (to image the small intestine) and barium enemas (to evaluate the colon or large intestine). Barium or other oral contrast agents may be used for CT examinations of the abdomen and pelvis, allowing better visualization of the GI tract. Over the next few posts we’ll be covering these imaging tests in detail.

 

Barium has been used for years and is inert, traveling through your system without being absorbed. It is well tolerated in almost all patients. After a study using barium, patients are advised to drink extra fluids in order to flush the barium out of their system.

 

Oh, and we promised a groaner of a pun too. What do you do with a chemist who has passed on? Barium!

(Image credit: Bariumsulfaat by Dr.T via Wikimedia Commons Copyright Creative CommonsAttribution-Share Alike 3.0 Unported)

 

Diagnostic Imaging Centers blogs on regularly about women’s health atwww.mammographykc.com and general radiology atwww.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!